How to Cut Health Care Costs; Interview with Herschel Walker; Is Weight Loss Worth the Risk of Surgery?

Aired April 19, 2008 - 08:30 ET

THIS IS A RUSH TRANSCRIPT. THIS COPY MAY NOT BE IN ITS FINAL FORM AND MAY BE UPDATED.

SANJAY GUPTA, CNN HOST: Welcome to HOUSE CALL, the show that helps you live longer. We're making the rounds this morning with the stories affecting your health and your wallet. First up, health care costs are soaring, from co-pays and premiums, to the medications you need every day. So we're investigating how we got here and what steps you can take to cut costs.

And when surgery feels like the only option, is the weight loss really worth the risk? Find out just ahead.

First up, though, the rising cost of health care. If a medical emergency were to strike your family, could you afford it?

(BEGIN VIDEOTAPE)

GUPTA (voice-over): Plummeting stock, homes in foreclosure, skyrocketing gas prices, the economy is issue number one for many Americans. One of the greatest concerns is the rising cost of health care. With nearly 100 million Americans either uninsured or underinsured, the health care system is in critical condition. And presidential candidates are making big promises.

SEN. JOHN MCCAIN (R), PRESIDENTIAL CANDIDATE: To help Americans without health insurance acquire it without bankrupting the country.

SEN. BARACK OBAMA (D), PRESIDENTIAL CANDIDATE: If you don't have health care, then we are going to make sure that you have health care. We are going to do it by the end of my first term as president of the United States of America.

GUPTA: The promises sound appealing, but those promises are going to take time and money to put in place. What about now? Consumers are feeling the pinch, and it's not stopping soon. New research projects that health care costs, including out-of-pocket expenses will rise 10 percent this year. According to patient advocates, something has to give. NANCY DAVENPORT-ENNIS, PATIENT ADVOCATE FOUNDATION: We're also operating at a loss. We have 300 million Americans. At some point, all of us will become a patient.

(END VIDEOTAPE)

GUPTA: You know, there are so many measures reflecting the state we're in, but this caught my attention. In less than ten years, the nation's hospital bill increased 89 percent. And that's just what the hospitals bill, not medication or wellness visit, for example, for your children.

Here to help explain what's going on with these skyrocketing costs, what you can do to stem the tide, is senior business correspondent Ali Velshi and personal finance editor Gerri Willis.

First of all, thanks for joining us.

GERRI WILLIS, CNN PERSONAL FINANCE EDITOR: Great to be here.

GUPTA: We hear the economy is issue number one.

ALI VELSHI, CNN SENIOR BUSINESS CORRESPONDENT: It is. And health care's a big part of this.

GUPTA: Yes, and I mean, you talk about this 24/7, Ali. There are so many indices that you look at every day to sort of get a reflection of what's going on here. Premiums are going up. Overall costs for health care are going up. What is going on? What's really driving that?

VELSHI: Well, health care is one of those areas where it's out of whack with inflation. The government says over the last year, inflation has been 4 percent. Well, not if you have -- if you're heavily weighted towards health care. Prescription costs are going up. And what's happening is insurers and companies, in order to control that, are passing more of those costs on to the user. And so we're just sort of absorbing those.

We're paying higher co-pays. The prices that we're paying are higher. The costs that we're paying, as you said, for health care up 10 percent. So that's the problem. It's going up and more of it is shifting over to the consumer of health care. And that doesn't include all those people who don't have any coverage at all.

GUPTA: Right. And sort of along those lines, people are also losing their jobs. You've been talking about the jobs rate for some time.

And Gerri, when people lose their jobs, so they're already in the hole, and now they're in the hole further. What should they be doing about health care?

WILLIS: Well, that's a tough question. When you lose your job, you have real problems. You have to go out into the marketplace, buy insurance on your own. This is very expensive to do. The state offers some kind of help, but I'm going to tell you it's a very expensive alternative. You've got to get back in that marketplace and get some employer-sponsored coverage, because that's really the only way back.

Look, you know, people who are employed have such great benefits. If you have a flexible spending account with your employer, you can set aside pre-tax dollars for all of these things Ali was just talking about. And let's see, if you're in the 28 percent tax bracket, you set aside $2,000, you're saving $560 a year in taxes.

GUPTA: Right, right.

WILLIS: Now let me just say one thing, though. If you use a flexible spending account, use the money. So many people let it go by the wayside. And the companies take that money. You don't get that money back.

VELSHI: You've got to spend it by the end of the year in which ...

WILLIS: That's right.

GUPTA: And they got awakening, a lot of them in April, just a couple days ago when they realize they hadn't maybe spent all of it. Deductible, high deductible plans, Ali, good idea, bad idea in the long term, short term?

VELSHI: The idea is it's meant to make you as a consumer a better buyer of your health care. You pay much more if you -- high deductible claims are great for people who don't think they're going to get sick.

The problem in this country isn't those people who are necessarily employed or those who don't get sick. As you have pointed out many times, the problem is when you get sick, you can't afford it. And in this time of high inflation, people are making choices against health care. They're making choices not to go to the dentist. They're making choices, even if they're sick, not to go to the doctor because they know what the outcome is. If they've got to fill a prescription, they can't.

So the bottom line with high deductible plans is it's a gamble that you are not going to have to ever pay that high deductible.

GUPTA: Right.

VELSHI: The market is not the best controller of health care. That's the bottom line. In America, it is not proven to be successful. We need better plans.

WILLIS: They have low costs. That's right. This isn't helping people who are older. Because as employers decide that this is the way to go, this is really going to leave older Americans out in the cold. They're going to have to pay more of their own money out of pocket.

GUPTA: All right. Well, hold that thought because we have a lot to talk about. Obviously, we just got started and we have so much already.

You at home need to know what is covered, but what about your medications specifically? And what steps can you do today to cut costs? We're going to have that in just 60 seconds.

GUPTA: Welcome back to HOUSE CALL. We're helping your health and your wallet today, breaking down the costs of your health care and more importantly, what you can do about it. With me, of course, CNN's personal finance editor Gerri Willis and senior business correspondent Ali Velshi.

Already having a great discussion about this. As you might imagine, you guys are doing all the time, but we got some e-mail questions on this. Ali, let me throw this to you. This comes from Dan in Georgia. He asks, "Why do Americans have to pay three, four, sometimes five times the price Canadians, Mexicans, and other countries pay for prescription drugs?"

VELSHI: The American government doesn't govern how much money these drug companies can make on drugs. In most countries of the world, Canada in particular, there is a limit on what drugs can cost. There are ways in which they control how much a new drug costs.

So a new drug has to be within the same price range as a drug that it replaces. A drug that treats something completely differently has to be set according to what the median price of that drug is around the world.

In the United States, those restrictions don't exist. And there are different patent protections for the drug companies. So the drug companies say they've got to make their money somewhere.

GUPTA: Right.

VELSHI: And they make it in the United States. Generic drugs are often cheaper in the United States than in other countries. It's brand name drugs that are generally cheaper in other countries.

GUPTA: And sometimes they'll say the cost of research, the cost of development all can be very expensive as well.

VELSHI: And they want to make up their money here. And they say it's a good, rich country and people can pay for it.

GUPTA: Right.

VELSHI: That is assuming you have coverage or you have money ...

GUPTA: Not everyone can. And speaking of which, Gerri, prescription drug costs, we sort of investigated this. 8 percent over the last year. Everyone feels this. We were just talking about this in the break. You go buy medications nowadays, you pay more money.

WILLIS: Absolutely.

GUPTA: What are you supposed to do?

WILLIS: No, I mean, it's appalling how fast the prices are going up. You've got to know the rules of your plan bottom line. You know, everybody wants you now not to go to your local pharmacy.

GUPTA: Right.

WILLIS: They want you to mail-order the stuff because it's so much cheaper. Again, you want to get your doctor in on this, because maybe it's what he's prescribing you. Maybe there's a cheaper drug out there.

There's also some great Web sites to use. Your plan probably has a Web site that'll tell you exactly how much the drugs that you want to buy. Also a Web site called drx.com. Now I can't emphasize how important it is to get your doctor in on this, because her or she can really guide you to something that'll work for you, but may not be as expensive as another medication.

GUPTA: Thanks to both of you for sticking around. This is obviously a very important issue to our viewers. You guys have been on double duty doing "ISSUE #1" all for the last month now. So I appreciate your time.

WILLIS: Thank you.

VELSHI: Thanks.

GUPTA: Thank you very much.

Now some breaking news this week. Accusations that many of the studies on Merck's blockbuster painkiller Vioxx were actually written by company employees or paid contractors, not independent scientists. That's according to a study in "The Journal of the American Medical Association."

That research is based on corporate and government documents from lawsuits over Vioxx. Merck has been named in more than 26,000 lawsuits by people who say the drug harmed them. You remember it was pulled off the market in 2004, after being linked to heart attacks. Merck calls the articles misleading and false.

Also in the news, a new study suggests a bigger brain may protect you against the ravages of Alzheimer's.

I want to show you something interesting here. This is what a brain looks like in a person who has plaques and tangles, the things that are often associated with Alzheimer's. Here they are right here. The plaques, the tangles.

The question was do these symptoms, do these plaques and tangles always lead to the problems with memory? And what they found was there was a small group of patients who showed signs of Alzheimer's, but did not suffer any memory loss. They think it's because those people actually had bigger brains. More specifically, a larger hippocampus, which is right here. The hippocampus was about 20 percent larger in people who did not have or suffer any of the memory robbing effects of Alzheimer's.

That's going be a fertile area of research for people trying to develop some better treatments.

We're going to have an exclusive interview with Herschel Walker. He's going to talk to me about living with multiple personalities in 60 seconds.

(COMMERCIAL BREAK)

GUPTA: He's a Georgia football icon with a long and successful NFL career. He also has a dark secret. Herschel Walker says his life was nearly derailed by his battle with Dissociative identity disorder. It's a mental health condition that can have terrifying consequences.

(BEGIN VIDEOTAPE)

GUPTA (voice-over): He was extraordinary, one of the greatest college football players ever. In the pros, a powerful force of nature. But Herschel Walker was living with a secret so confusing, so bizarre, he wasn't even aware of it. His ex-wife Cindy says there's more than one Herschel, and some of them are terrifying.

CINDY GROSSMAN, WALKER'S EX-WIFE: He definitely sounded different. Sometimes his body would contort. His hands would curl up like this. He would tell me he couldn't walk. His -- to me, his skin would become darker. And if it was a very bad alter, his eyes would become very evil.

GUPTA: Herschel Walker is like Sally Fields character in the TV movie "Sybil," the woman with more than a dozen different personalities.

HERSCHEL WALKER, FORMER NFL PLAYER: You know, to be honest with you, I don't -- you know, I'm thinking, this is not real. This is not real. But you know, my life is out of control. I was not happy. I was very sad, I was angered. And I didn't understand why.

GUPTA: In fact, neither Sybil nor Herschel Walker have multiple personalities. Instead, they have fragments. Think of it as alter personalities that prevent them from developing a single cohesive personality. Today the disorder is called DID or Dissociative Identity Disorder because they can't integrate identity, memory, and consciousness.

How hard was it to get diagnosed?

WALKER: That was very difficult. People don't believe it. In the back of this building right here, there was like a -- there was a playground. I remember this guy beating me up.

GUPTA: The alter personalities can evolve after a child suffers both physical and mental abuse.

WALKER: The abuse may have been feeling inadequate as a little kid, you know, having a speech impediment, a little bit overweight, being mentally abused by friends, by -- you know at school.

GUPTA: Walker said some of his alters did a lot of good, helped him become the extraordinary athlete he is. But others caused a lot of harm. They became very angry.

WALKER: You can get angry, but the anger that you can go out and really, really hurt someone. And that's when you know you got a problem.

GUPTA: And typically, patients don't remember transforming from one alter to the next. Do you worry that you might hurt somebody?

WALKER: I don't worry about that.

GUPTA: But you don't remember. So I mean ...

WALKER: Because no one has ever said anything about it. You know, I haven't been locked up. I haven't been accused of beating up nobody.

GUPTA: But he did try to hurt at least two people.

GROSSMAN: Did he hurt me where I had to go to the hospital? No. Just more emotionally scary than physically -- where he physically hurt me. So just the guns and knives and -- I got into a few choking things with him.

GUPTA: And he almost killed himself.

You played Russian Roulette?

WALKER: I played Russian Roulette before and stuff. More than once. I played it more than once, because see, to me that was a challenge. And that's what I'm saying. That made no sense.

GROSSMAN: He would tie those thick rubber bands around his neck and just walk back and forth. And when it got bad enough, he'd take it off.

JERRY MUNGADZIE, WALKER'S THERAPIST: I saw all the Herschels. Some of the very friendly, nice, business-like people. I saw some of the protectors, who are very defensive. And a few times only did I see the very angry ones.

GROSSMAN: He held a gun to my temple and said he was going to blow my brains out.

GUPTA: The Herschel Walker I met was friendly. I didn't notice any behavioral changes. He seemed to have more control over all of his alters, but they are still there.

(END VIDEOTAPE)

GUPTA: And in response to what his former wife says, Herschel Walker told us he was troubled by his actions and will always deeply regret any pain he caused Cindy.

Up to seven percent of U.S. adults will suffer from dissociative identity disorders in their lifetime. And effective treatment can be available. So if you or someone you know experiences symptoms like unexplained memory loss, dramatic changes in behavior, or a sense sometimes that the world is unreal, please contact a health professional.

And later in the show, imagine being locked up in your own home, afraid of what people might think of you. Find out what drastic measure this woman took to change her life.

And a service that allows patients to rate their doctors like rating a restaurant. It's one of the latest medical trends on the Internet. We'll have details. That's next.

(COMMERCIAL BREAK)

GUPTA: We are back with "HOUSE CALL." So how do you find a new doctor? Well, the worldwide web may have some clues. Doctor rating sites are the latest medical trend. Think of it as sort of an online word of mouth.

And Elizabeth Cohen, of course, is here to empower us using this new tool. I mean, people talk about dating sites, Elizabeth. Is this sort of like a dating site, a doctor site? What is it?

ELIZABETH COHEN, CNN MEDICAL CORRESPONDENT (voice-over): You know, it's a bit like a dating site, Sanjay. There are tons of these sites. And people basically go on and they dish about their doctors. So you can put in your doctor's name or you can put in your zip code. And you can find out what people have to say about your doctors.

Here are some comments that are kind of typical that we found on one Web site. Someone says Dr. X, that obviously isn't the doctor's real name, is extremely capable and caring. And someone else said, Dr. X is quite pretentious and does not value patient-physician relationship.

Now it's interesting. Even Angie's List ...

GUPTA: Yes.

COHEN: ...the place you go to find a plumber, even they're getting into the act now.

GUPTA: You know, it's interesting. I have found that people typically, when they're upset about something or they want to complain, they're more likely to go to one of these sites and actually write something. Whereas if they're happy, they typically don't. I mean, how do you sift through all this information that's out there?

COHEN: Sanjay, that is so true. People do typically tend to go when they have a lot to complain about. So here's some things you want to look for when you're sifting through these comments.

First of all, you want to look for specifics, not adjectives. Terrible doctor doesn't really help you, but doctor couldn't get me in when I was sick, doctor didn't call me back, things like that. You want to look for that.

Also, look for patterns. So for example, if five people are saying the exact same bad thing or good thing about a doctor, that tells you more than just five random comments. Go to cnn.com/empoweredpatient. So we give you the links to find out is your doctor board certified? Do they have any malpractice judgments against them? Information like that.

GUPTA: All right, Elizabeth, as always, our "Empowered Patient" advocate, I really appreciate it. Thank you very much for being here.

GUPTA: It's time for our segment "Ask the Doctor." We find out the medical questions that are on your minds. Ramesh from California had this question for me.

(BEGIN VIDEO CLIP)

RAMESH: I was recommended medicine for lowering high blood pressure. Do I have to take this medicine forever? When can I discontinue this treatment? (END VIDEO CLIP)

GUPTA: Ramesh, I would say maybe. But I'm going to preface that by saying you should always check with your doctor before discontinuing any medication. High blood pressure is a dangerous condition, but experts say a healthy lifestyle alone may help you control it. For some people, just losing around 10 pounds can allow you to reduce, possibly even stop your medications.

So make sure you maintain a healthy weight. Also, an important one, keep salt to a minimum. Eat a diet rich in fruits, vegetables, whole grains, and fiber. And limit your alcohol intake as.

Let me just take a second and explain what's going on when you have high blood pressure. This is your heart pumping blood normally through flexible open arteries. Now when your heart is pumping out a higher volume of blood, and there's resistance in the arteries, that causes high blood pressure, making your heart work even harder than it should to force blood through the system. It's a little primer on what's happening there, Ramesh. Hope that helps.

Now what would you do if you felt like every day might be your last? You're going to want to stay tuned for the extreme decision this woman made to save her own life. Right after the break.

(COMMERCIAL BREAK)

GUPTA: We're back with HOUSE CALL. You know, when it comes to weight loss, there's no magic bullet. We talk about that all the time. A healthy diet and exercise are of course key, but some are turning to a controversial operation to get back on track.

(BEGIN VIDEOTAPE)

GUPTA (voice-over): Just two years ago, Brandee Howell refused to look in the mirror. She hated being in pictures. And often, she wouldn't even leave the house. She was more than 400 pounds, unhappy, and truly believed her days were numbered.

BRANDEE HOWELL: I was 28, 29-years old at the time . And I felt like every day was going to be my last. I had high blood pressure. I was borderline diabetic.

GUPTA: Concerned about her health and her morbid obesity, her doctors strongly recommended she have gastric bypass surgery.

HOWELL: I was a little nervous, but I was more scared of dying from a heart attack at a young age, or not waking up because I had sleep apnea in the middle of the night than going in for surgery.

GUPTA: After two months of planning, testing, counseling and doctors visits, Brandy had surgery at Hurley Medical Center in Michigan.

HOWELL: And absolutely the best decision I've ever made without question. GUPTA: Now two years later and more than 200 pounds lighter, Randy says she's a new person, but she still has difficult days.

HOWELL: I have some days where I feel miserable and I feel fat. It's almost like phantom fat pains I guess. I feel horrible. And I have to stop and pull out clothes that I used to wear, look at them, crawl into them, and realize that somebody else can crawl into them, too, and put myself back in that place mentally.

GUPTA: Brandee says her journey was long, but it has taught her to be confident and enjoy life.

HOWELL: I want to go bungee jumping. I mean, I want to water ski. I want to roller blade, do horse back riding. That's something I've always wanted to do and I never could.

My name is Brandee Howell, and I've lost approximately 247 pounds.

(END VIDEOTAPE)

GUPTA: Well, unfortunately, that's all the time we have today. If you missed any part of today's show, be sure to check out my podcast on CNN.com/podcast. Remember, this is the place for the answers to all of your medical questions. Thanks for watching. I'm Dr. Sanjay Gupta. More news now on CNN starting right now.